Tobii Pro, Reston, VA, USA.
Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.
Dev Sci. 2020 Sep;23(5):e12953. doi: 10.1111/desc.12953. Epub 2020 Mar 10.
Although difficulties with social relationships are key to autism spectrum disorder (ASD), no previous study has examined infant attachment security prior to ASD diagnosis. We prospectively assessed attachment security at 15 months in high-risk infants with later ASD (high-risk/ASD, n = 16), high-risk infants without later ASD (high-risk/no-ASD, n = 40), and low-risk infants without later ASD (low-risk/no-ASD, n = 39) using the Strange Situation Procedure. High-risk/ASD infants were disproportionately more likely to be classified as insecure (versus secure) and more likely to be classified as insecure-resistant (versus secure or avoidant) than high-risk/no-ASD and low-risk/no-ASD infants. High-risk infants with insecure-resistant attachments were over nine times more likely to receive an ASD diagnosis than high-risk infants with secure attachments. Insecure-resistant attachment in high-risk infants suggests a propensity toward negative affect with the parent in conditions of stress. Insecure-resistant attachment may prove useful as a potential early index of propensity toward ASD diagnosis in high-risk siblings, while insecure-resistant attachment in the context of emergent autism may contribute to difficulties experienced by children with ASD and their families.
尽管社交关系困难是自闭症谱系障碍（ASD）的关键，但以前没有研究在 ASD 诊断前检查婴儿的依恋安全性。我们前瞻性地在 15 个月时使用陌生情境程序评估了高风险婴儿（高风险/ASD，n=16）、高风险无后续 ASD 婴儿（高风险/无 ASD，n=40）和低风险无后续 ASD 婴儿（低风险/无 ASD，n=39）的依恋安全性。与高风险/无 ASD 和低风险/无 ASD 婴儿相比，高风险/ASD 婴儿更容易被归类为不安全（相对于安全），更容易被归类为不安全抵抗（相对于安全或回避）。具有不安全抵抗依恋的高风险婴儿被诊断为 ASD 的可能性是具有安全依恋的高风险婴儿的九倍以上。高风险婴儿的不安全抵抗依恋表明，在压力条件下，婴儿与父母的消极情绪倾向。不安全抵抗性依恋在高风险兄弟姐妹中可能是 ASD 诊断倾向的潜在早期指标，而在自闭症出现的情况下，不安全抵抗性依恋可能会导致 ASD 儿童及其家庭所经历的困难。
